Provider Demographics
NPI:1164534301
Name:DOYLE, WERNER K (MD)
Entity Type:Individual
Prefix:
First Name:WERNER
Middle Name:K
Last Name:DOYLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1838
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10156-1838
Mailing Address - Country:US
Mailing Address - Phone:212-981-7274
Mailing Address - Fax:212-209-3252
Practice Address - Street 1:223 E 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4852
Practice Address - Country:US
Practice Address - Phone:646-558-0804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1578071207T00000X
NJMA68391207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01471278Medicaid
NJ6047203Medicaid
NJ036738TFLMedicare PIN
NYWFW941Medicare PIN
NY01471278Medicaid
NJ6047203Medicaid